Total Knee Replacements at an All Time High

We all know someone who has had a total knee replacement. In fact, most of us probably know someone who has had more than one. It’s likely a parent, grandparent, maybe a friend. My mother had her knee replaced after an ACL tear at a young age and the wear and tear of Osteoarthritis. While the surgery benefited her pain initially, it taught her nothing about how to manage her joint moving forward, how to exercise safely, and how to avoid having another replacement down the line given knee replacements typically last 15-20 years (1). She has always been active, but only now, decades after the replacement, has she learnt about the preventative benefits of individualised exercise treatment for her knee health.

My mother’s story is representative of an older system of healthcare that leans toward surgical fixes rather than prevention and treating the source of an issue. This fails to acknowledge the advancements of allied health professionals, such as Exercise Physiologists, within that system. Even with these developments to accessibility and effectiveness of more conservative approaches, rates of knee replacement surgeries have soared, almost tripling over the last 20 years.

 

While most surgeries provide initial relief to joint pain for clients, they fail to address the underlying causes of joint degeneration, and how to avoid the major physical and financial undertaking of another total knee replacement. Many large-scale studies now show there is no significant difference in long-term outcomes between an invasive surgery, and individualised exercise treatment (2).

“A shift towards prevention of these causes through individualised exercise prescription could not only eliminate the potential issues of invasive surgery (infection, damage to local tissue, bleeding etc.) but it could be a much more cost-effective form of treatment, with most Total Knee Replacements in Australia costing an average of $26,975” (3)

 

How can Exercise Physiologists help you avoid a replacement?

Two major factors that increase the risk of a knee replacement are obesity, and work with a repeated, intense physical load to the knee joint. Obesity is directly related to a higher rate, and earlier incidence of knee replacement in both males and females. It was particularly higher in women aged 45-54 who were almost 25x more likely to have replacement than women of the same age with a normal BMI (4).

Women aged 45-54 with severe obesity (>40BMI) were 24.9x more likely to have a knee replacement than women of the same age range with a normal BMI.

An individualised exercise program that manages safe levels of loading through the knee, using exercise such as cycling or swimming, whilst building muscular strength around the knee to support function at the joint is an effective way to reduce the need for surgical intervention and improve function and quality of life.

One of our Exercise Physiologists at any of our  Drummoyne, EdgecliffMarrickvilleCastle HillRandwickPymbleKingsgrove, Neutral Bay or Coburg locations can help to build an exercise program and lifestyle that can help reduce knee pain and improve your longevity. Give us a call on 1300 964 002.

 

  1. Evans, J. T., Walker, R. W., Evans, J. P., Blom, A. W., Sayers, A., & Whitehouse, M. R. (2019). How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. The Lancet393(10172), 655-663.
  2. Kirkley, A., Birmingham, T. B., Litchfield, R. B., Giffin, J. R., Willits, K. R., Wong, C. J., … & Fowler, P. J. (2008). A randomized trial of arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine359(11), 1097-1107.
  3. https://www.bupa.com.au/health-insurance/surgery-cost-calculator/knee-replacement-surgery-cost
  4. Wall, C. J., de Steiger, R. N., Vertullo, C. J., Stoney, J. D., Graves, S. E., Lorimer, M. F., & Kondalsamy‐Chennakesavan, S. (2022). Obesity is associated with an increased risk of undergoing knee replacement in Australia. ANZ Journal of Surgery92(7-8), 1814-1819.

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